Medical-surgical Nursing Demystified

(^224) Medical-Surgical Nursing Demystified

• Irradiation of the area to decrease tumor size.


• Craniotomy to remove the tumor if appropriate; this depends on location,
  size, primary site of cancer, and number of tumors. Some patients may have
  several small, scattered tumors, making surgery impractical.


• Administer glucocorticoid to reduce swelling or inflammatory response
  within confined space inside skull (no room to expand, bone does not give):
  
  
  • dexamethasone
  
  
  
  


• Administer osmotic diuretic to reduce cerebral edema:
  
  
  • mannitol
  
  
  
  


• Administer anticonvulsant to reduce chance of seizure activity:
  
  
  • phenytoin, phenobarbital, carbamazepine, divalproex sodium, valproic
    acid, levetiracetam, lamotrigine, clonazepam, topiramate, ethosuximide
  
  
  
  


• Administer mucosal barrier fortifier to reduce risk of gastric irritation:
  
  
  • sucralfate
  
  
  
  


• Administer H2 receptor antagonists to reduce risk of gastric irritation:
  
  
  • ranitidine, famotidine, nizatidine, cimetidine
  
  
  
  


• Administer proton pump inhibitors (PPIs) to reduce risk of gastric irritation:
  
  
  • lansoprazole, omeprazole, esomeprazole, rabeprazole, pantoprazole
  
  
  
  

NURSING DIAGNOSES

• Disturbed sensory perception


• Risk for injury

NURSING INTERVENTION

• Monitor neurologic function.


• Check for side effects to medications.


• Seizure precautions per institution protocol.


• Assess for pain control.


• Explain to the patient:
  
  
  • Home care needs.
  
  
  • Possible need for hospice.